Paramedics warned against Viagra, nitroglycerin mix

Patients should not receive nitroglycerin for heart treatment within 24 hours of using Viagra

Potential health threat to patients cited

May 21, 1998
Web posted at: 9:48 a.m. EDT (1348 GMT)

SAN DIEGO (CNN) -- A word of caution about Viagra, the popular anti-impotence pill, is being re-emphasized to emergency medical personnel in order to avoid a potentially life-threatening situation with heart patients.

Paramedics in San Diego's Emergency Medical Services (EMS) system have been told they should screen potential recipients of nitroglycerin -- both men and women -- for prior Viagra use. Nitroglycerin is often used in emergencies to treat chest pains.

CNN's Dr. Steve Salvatore talks about the dangers of Viagra and nitroglycerin

The screenings could prove difficult in cases where a heart patient is unable to communicate with emergency medical personnel or in cases where a man is embarrassed to acknowledge he is being treated for impotence.

San Diego's caution follows a previous advisory from Pfizer Pharmaceuticals, the maker of Viagra. The company warned that heart patients should not be treated with nitroglycerin if the patient has used Viagra in the previous 24 hours.

Pfizer says there have been cases where patients who received both drugs have died after developing irreversible hypotension, a severe drop in blood pressure.

Nitrates, a component of nitroglycerin, can cause blood pressure to drop and Viagra greatly increases that effect.

Although Viagra is packaged with this warning, medical experts say the caution may go unnoticed. For that reason, doctors and pharmacists are advised to warn their Viagra patients of the potential danger.